ATI RN
Complications of Postpartum Questions
Question 1 of 5
Lacerations of the cervix, vagina, or perineum are also causes of PPH. Which factors influence the causes and incidence of obstetric lacerations of the lower genital tract? (Select all that apply.)
Correct Answer: A
Rationale: A. Operative and precipitate births: Obstetric lacerations of the lower genital tract are more likely to occur during operative deliveries (such as forceps or vacuum-assisted deliveries) and precipitate births (very rapid deliveries) due to the increased forces and speed involved during these types of deliveries.
Question 2 of 5
The nurse continues to monitor a patient after a vaginal delivery with an estimated blood loss of 1,000 mL. Which assessment finding does the nurse recognize as requiring Stage 3 hemorrhage protocol?
Correct Answer: C
Rationale: In this scenario, option C, "Development of abnormal vital signs," is the correct answer that would require Stage 3 hemorrhage protocol. Postpartum hemorrhage is a leading cause of maternal mortality globally, and prompt recognition and intervention are crucial. Abnormal vital signs such as tachycardia, hypotension, and tachypnea can indicate significant blood loss and hemodynamic instability, necessitating immediate action to prevent further complications or potential death. Option A, "Increased patient restlessness," is not specific or sensitive enough to indicate the severity of postpartum hemorrhage. Restlessness can be a nonspecific sign and may not always correlate directly with the need for Stage 3 hemorrhage protocol. Option B, "Manifestations of severe pain," while important to assess and manage, is not a primary indicator of the need for Stage 3 hemorrhage protocol in postpartum patients with significant blood loss. Severe pain may result from uterine contractions or other factors and does not directly reflect the patient's hemodynamic status. Option D, "Patient requests water for extreme thirst," is also not a direct indicator of the severity of postpartum hemorrhage. Thirst can be a common postpartum complaint and may not necessarily signify the need for immediate intervention related to hemorrhage. Educational Context: Educating nurses on postpartum hemorrhage complications is essential for early recognition and intervention. Understanding the progression of hemorrhage stages and associated assessment findings can help nurses provide timely and appropriate care to prevent adverse outcomes in postpartum patients. Regular training and simulations can further enhance nurses' skills in identifying and managing postpartum hemorrhage effectively.
Question 3 of 5
The nurse is closely monitoring a patient who is postpartum and at risk for PPH. Which assessment finding will cause the nurse to contact the primary care provider immediately?
Correct Answer: D
Rationale: In this scenario, the correct answer is D) Peripad weighs 100 g within 15 minutes. This finding indicates excessive postpartum bleeding, which is a significant concern as it suggests a risk of postpartum hemorrhage (PPH). Immediate notification of the primary care provider is crucial to initiate prompt interventions and prevent further complications. Option A) The uterus is displaced may indicate a full bladder or uterine atony, which are important to address but do not represent an immediate threat as much as severe bleeding does. Option B) The uterine fundus is boggy suggests uterine atony, a common cause of PPH, but it does not indicate active bleeding as directly as option D. Option C) Small clots being expressed with massage are a normal finding in the immediate postpartum period and do not necessarily indicate significant bleeding. In an educational context, understanding the assessment findings and interventions for postpartum complications like PPH is crucial for nurses caring for postpartum patients. Recognizing early signs of PPH and knowing when to escalate care are essential skills to ensure the safety and well-being of the mother. Regular simulation training and case studies can help reinforce this knowledge and enhance clinical decision-making in these critical situations.
Question 4 of 5
The nurse is providing postpartum care for a patient after a vaginal delivery. Which assessment finding causes the nurse to suspect endometritis from beta-hemolytic streptococcus?
Correct Answer: D
Rationale: Rationale: The correct answer is D) Elevated temperature greater than 100.4°F (38°C) because endometritis, inflammation of the uterine lining, commonly caused by beta-hemolytic streptococcus, presents with fever as a hallmark symptom. This indicates an infectious process that requires immediate attention and treatment. Option A) Scant amount of odorless lochia is not specific to endometritis caused by beta-hemolytic streptococcus. It may occur in the normal postpartum period. Option B) Presence of headache, malaise, and chills are non-specific symptoms that can be present in various postpartum conditions, not specifically indicative of endometritis from beta-hemolytic streptococcus. Option C) Pain or discomfort in the midline lower abdomen can be seen in endometritis, but the hallmark symptom is an elevated temperature in the setting of postpartum care. Educationally, understanding the signs and symptoms of postpartum complications such as endometritis is crucial for nurses providing postpartum care. Recognizing specific indicators like fever can prompt timely intervention and prevent further complications for the mother. This knowledge enhances the nurse's ability to provide safe and effective care to postpartum patients.
Question 5 of 5
The nurse is preparing discharge teaching for a postpartum patient who exhibits signs and symptoms of an episiotomy infection and is on oral antibiotic therapy. Which discharge teaching will the nurse provide regarding pain management?
Correct Answer: B
Rationale: In this scenario, the correct answer is option B) Information applicable to medication therapy. The rationale behind this is that when a postpartum patient is experiencing signs and symptoms of an episiotomy infection and is on oral antibiotic therapy, it is crucial to provide education on medication therapy for pain management. It is important for the nurse to ensure the patient understands the prescribed pain medication regimen, including dosage, timing, potential side effects, and interactions with antibiotics. Option A) Application of hot packs to the perineal area may provide temporary relief but does not address the underlying issue of infection or provide effective pain management in this case. Option C) Instructions to improve circulation by ambulating is important for overall recovery but may not directly address the pain associated with the episiotomy infection. Option D) Medicating for pain above level 4 on a 0 to 10 scale is vague and does not provide specific guidance on pain management tailored to the patient's condition and medication regimen. In an educational context, understanding the rationale behind pain management strategies in postpartum patients with complications is essential for nurses to provide safe and effective care. By teaching medication therapy specifics, nurses empower patients to manage their pain effectively, promoting better outcomes and patient satisfaction.